Idiopathic Small Fiber Neuropathy - chest pressure/tighteness

@sf2021 - I have idiopathic small fiber PN but have never experience chest tightness that I felt was associated with small fiber neuropathy. Hoping others who can relate will respond to your question. This sounds like it could be serious. Have you discussed the symptoms with your doctor or neurologist?

Here's some information I found that sounds similar to what you are describing - "a squeezing pressure sensation that wraps around the chest from front to back; tingling; numbness. The pain might feel worse even when doing gentle physical ..." - Intercostal Neuralgia: Symptoms, Causes, Medication, Other: https://www.healthline.com/health/intercostal-neuralgia

Thanks, John. I checked out the site, this is helpful. I don't have any pains from breathing or touching the rib area. I have an appointment with the neurologist. I was wondering if anyone else had any similar symptoms. Thanks again.

Hello - I too have idiopathic SFN with pressure and tightness around the chest and rib area. I have experienced this intermittently throughout the day for years. Whenever I have mentioned this to my neurologist in the past, he has explained that SFN can affect any part of the anatomy. I have accepted this explanation and I deal with it the best I can. I find anti-inflammatories work the best but only take them when I absolutely need them. If you receive any other advice, I would greatly appreciate you sharing it.

I have had this or something similar for about 2 years. Mine is just below the breasts and seems to run mostly across the chest from side to side in the front, less so in the back. It is a feelin of pressure. I've mentioned it to every doctor (neurologist, gastroenterologist, PCP, etc. with no answer. Finally got my PCP to order a CT scan of the abdomen. Result shows some heart enlargement. Echocardiogram and angiogram of heart show only slight thickening of left ventricle wall which ruled out cardio as a source of this symptom. Cardio also found that I have "monophasic flow" which has to do with blood in lower extremities not flowing back to the heart as it should. I recently started having very low blood pressure. Gastroenterologist did endoscopy and found gastritis and small hiatal hernia. The hiatal hernia seemed to me the most suspect for cause of this mystery feeling. So far nothing prescribed has affected it. When I exert or get stressed (notably having to explain symptoms to my doctors causes me to get out of breath) it becomes much tighter and I FEEL like I can't fill my lungs or take a deep breath, but my oxygen level is normal. I find that I am slumping over when sitting and sometimes when walking and I had suspected this might have to do with the muscles in that area becoming weaker and my posture becoming worse. I also notice that I have to eat smaller amounts of food or the pressure is worse. I'm taking gabapentin for pain and tramadol only as needed. My gastroenerologist prescribed Citrucel and Miralax for constipation and Pepcid and Aloe Vera gelcaps (I guess for the gastritis. My PCP prescribed ezetimibe (Zetia) for cholesterol control. I take vitamin d3 (4000 units a day) and supplemental Calcium (1200 units a day) for osteoporosis. I also get monthly injections of Evenity for osteoporosis. All of which are known to my various doctors. I have also been treated for post-treatment Lyme disease, (probably unsucessfully), which I think may be a factor in my neuropathy. I offer all this information in case any of it corresponds with anyone else's profile.

I am somewhat relieved to hear that others have this chest tightness - that it is not in my head. I am a little surprised it may be one effect of the neuropathy although that makes sense I guess. I am starting PT this week and I hope to find exercises to strengthen my back and correct posture among other things and see if that lessens this feeling.

Thank you to everyone who has reported this and I hope my posting helps too. I wish we could get our doctors to recognize this.

tappanzee, I will definitely report back after I speak with my neurologist (I am not optimistic on a solution but will report back regardless). I am on 300mg gabapentin at night but I don't think this helps the chest pressure. This symptom bothers me the most. The only time I feel better is when walking outside / moderate exercise. But comes back soon thereafter. You say you take anti-inflammatories, do you mean Advil or something stronger? Does it work effectively?

My pressure is in the same exact place, below the breast line only on the front, so you are not alone and definitely not imagining. I asked for an abdominal ultrasound as well. For me, the pressure is random. The pressure lessens during walking or doing exercises. I will report back after my sessions with the doctors.

sf202, I had been taking gabapentin for over 2 years but found it did nothing to alleviate my pain. Although I have symptoms throughout my body, I agree that the chest, back, and rib pressure and pain is the worst. It is very restrictive although like you, I do find that light exercise does help for the moment. Perhaps it is just that I am just taking my mind off the pain for a short period of time. When the pain is intense, I take some Advil and it seems to take the edge off things for a while. I also agree with Catharbert that it is best to eat smaller amounts of food or I find that the pressure and pain are worse. Lately, I have been experimenting with CBD oil capsules especially at night in an attempt to get a better night's sleep. So far, it seems to help but nothing I have tried so far eliminates the pain completely.

I also have idiopathic SFN and it sounds like you also have “non-length dependent” neuropathy as I have. Over the past few months I have been having sensations on my chest wall that are difficult to describe. A little pressure yes but also something almost like a muscle spasm. They are usually in only one side of the chest wall at a time, more frequently on the left but other times on the right. Usually right beneath my breast but occasionally on my lower ribs. Although 72, I have a strong heart with the blood pressure of a child. i have thought about going back to the cardiologist since heart problems in women can present differently than is typical for men. But the pressure seems to be too superficial to be my heart. And the location is sometimes no where near my heart. Sounds like a similar problem to yours.

I had a stroke in '19 I was left with dysesthesia all on the left side of my body. I have tightness on the whole left side. I can tolerate the arms and legs and sometimes my face and especially my hand but when it tightens up on my ribs around the breast area it makes me feel like I cannot breath. It feels like someone is sitting on my chest sometimes and it makes it hard to breath even though my oxegen level is fine. Putting an ice bag on it helps. Laying down helps me. It seem to appear when the weather changes to cold or a storm coming through or high stress. Doctors do not understand this problem because it is not a visible thing. I read it is what MS patients suffer the "MS hug"

I had promised to report back after speaking with my neurologist on this symptom. He did not think the chest pressure was associated with SFN. He didn't have a view on what else could cause it (!). I asked another neurologist and she agreed it is not a directly attributable symptom but thought it could be caused by anxiety brought on by SFN. When asked if there is any medication for this, she didn't have any aside from a muscle relaxant. In all, not very helpful but I wanted to share.